‘The Changing Life Trajectories Project’ (CLT)

1. ‘The Changing Life Trajectories Project’ (CLT) Designing nurse home-visiting services for CALD families who are experiencing low levels of risk Dr Wendy Foote Principal Investigator UNSW Ms Jennifer Evans -Communication Matters Ms Nicole Bechard TIHC&FS

2. The Infants’ Home Child & Family Services (TIHC&FS) Providing education, health, support and care for 135 years Sydney Hope Family Cottage (SHFC) • Day Stay & Home Visiting Service • Infant and maternal/family health services • Child & Family qualified nurses with training in the Family Partnership Program • High CALD population – 37% in LGA

3. History & Background Why this program? Partnership between three agencies Health research reference group

4. United Way Sydney • The vision: social entrepreneurship • The funding • The submission: • A commercially operated profit-making clinic at TIHC&FS • 2. CLT- • The early intervention service • Sustained Nurse HV • first 12 months of a baby’s life

5. The University of New South Wales • Wendy Foote - Lecturer, Social Work practice Previously Manager TIHC&FS, involved in providing early intervention services Continuity of involvement after writing the original submission

6. From Submission to Action

7. Reference group Membership: Clare Rogers – Director, Prevention & Early Intervention, DoCS Professor Cathrine Fowler- Child &Family Health Nursing Midwifery & Health UTS. Dr Lynn Kemp- Program Manager, Early Childhood Research, Centre for Primary Health Care & Equity UNSW; UTS Honorary Associate (Child & Family Health);Deputy Director, Program Development, Sydney South West Area Health Service Jennifer Evans –Communication Matters Dr Wendy Foote – Principal Researcher, Lecturer, Social Work Practice, UNSW. Nicole Bechard – Manager, TIH C&FS

8. Significant factors: Scoping the area • The organisational match • Lit review – unpublished/published/local • Research gap • Local needs • Patterns of service use • Population trends • Experts

9. Sequence 3 jigsaw pieces • Q. The ‘risk’ levels of target group 2. Q. What service model and what data did we want to collect? 3. Research questions, methods and data collection.

10. Refined Questions & Target Groups Criteria: • Low risk ie ‘isolation’ • Recent arrival from India, Sri Lanka, Bangladesh, Pakistan • Proximity to service provider • Good use of English

11. Aim of the research • …to investigate the effectiveness of the ‘Changing Life Trajectories’ program. • The program is designed to improve parent effectiveness in populations where there are low levels of risk.

12. CLT program Program Components: • Parent craft • Parenting education • Social linking and building • Strength based approaches • Family partnership training (Davis, Day & Bidmead) • STEEP program (Martha Erickson)

13. Research questions: • Confidence/responsiveness 2. Knowledge of infant/child development 3. Mental health: mother/family/child 4. Social isolation 5. Social connectedness 6. Use of services 7. Influence of culture /migration 8. Most useful intervention?

14. Methods Data will be collected by survey- scales questions from NSW Child Health Survey. Thematic data will be gleaned from group discussions.

15. Measures • McMaster Family Assessment Device (section 7 only) • Social support • Edinburgh Depression Scale • ‘Home’- assessment of the environment • Health data • Modified Abidin parenting Stress Index (Life events inventory) • Parent knowledge of preventive infant care • Parent reports on child abuse reports • Parent reports on utilization of health and parent support services • Parent knowledge and use of child care

16. Current stage • Ethics application in with RPA- followed by approaches to antenatal clinics at Canterbury and RPA hospitals • Training of staff • Development of survey • Identification of points of referral • Intake Jan 10

17. Research in Reality • Challenges • Balance of priorities • Demystifying research • Right people • Ongoing funding • Working within systems • Commitment